KUALA LUMPUR: A public health expert has warned that the swine flu could be as big a killer as the 1918 Spanish flu which left 40 million people dead, if it is not properly contained.

Universiti Sains Malaysia Public Health professor with a doctoral in epidemiology Dr Chan Chee Khoon said some people think it would not be serious but if the virus replicates the characteristics of the Spanish flu, many could be infected or die.

With the World Health Organisation raising the alert level for swine flu epidemic to five, there has been concern that the A/H1N1 swine flu virus strain could prove just as dangerous.

Dr Chan said the swine flu epidemic was harder to control than the Severe Acute Respiratory Syndrome (SARS) but not as deadly.

"The flu virus becomes infectious even before symptoms are seen and this makes it difficult for health authorities to contain the disease," he told The Star.

Dr Chan who spoke at the just-concluded 'Health Systems in Transition' workshop said emphasis on knowledge was important, citing that during the Nipah Encephalitis epidemic 10 years ago, pig farmers were infected after they injected the pigs because it was initially thought that it was Japanese Encephalitis, which was transmitted by mosquitoes.

However, Universiti Malaya Medical Centre infectious disease head Prof Dr Adeeba Kamarulzaman said there were advantages in modern health practices and medicine that could help prevent the swine flu from becoming a repeat of the Spanish flu.

"Moreover, back then, there was a lack of medical care and it was towards the end of World War I where people were starving," said Dr Adeeba who presented a paper on Emerging Infectious Diseases.

"With better living today, hopefully we won't see that kind of numbers," she said, adding that our understanding of infection control was the most important thing.

-The Star/Asia News Network